TABLE 3.
Quality improvement activities implemented by RNXs, stratified by educational level and organized according to the Quality Assurance and Performance Improvement (QAPI) elements.
| Quality improvement activities implemented by RNXs in their current nursing home: % yes | Overall (n = 104 RNXs) n (%) | Missing n (%) | Diploma (n = 48) n (%) | Bachelor (n = 35) n (%) | Master (n = 17) n (%) | SMD | p‐value |
|---|---|---|---|---|---|---|---|
| Governance and leadership | |||||||
| Handling complaints from residents or their relatives | 75 (72.1) | 0 (0.0) | 32 (66.7) | 27 (77.1) | 13 (76.5) | 0.16 | 0.52 |
| Handling reported errors (e.g. CIRS) | 50 (48.5) | 1 (1.0) | 19 (39.6) | 20 (58.8) | 9 (52.9) | 0.26 | 0.21 |
| Organizing/conducting surveys on residents' satisfaction | 39 (37.5) | 0 (0.0) | 17 (35.4) | 16 (45.7) | 4 (23.5) | 0.32 | 0.28 |
| Organizing/conducting surveys on staff's satisfaction | 34 (32.7) | 0 (0.0) | 17 (35.4) | 13 (37.1) | 1 (5.9) | 0.55 | 0.05 |
| Feedback, data systems and monitoring | |||||||
| Setting quality goals for the NH or for specific units | 80 (76.9) | 0 (0.0) | 34 (70.8) | 28 (80.0) | 15 (88.2) | 0.29 | 0.30 |
| Giving feedback to the team about the quality of care provided by the NH (e.g. key figures) | 77 (74.0) | 0 (0.0) | 34 (70.8) | 25 (71.4) | 15 (88.2) | 0.29 | 0.34 |
| Comparing the results of the NH or of specific units with set quality goals | 70 (67.3) | 0 (0.0) | 27 (56.2) | 25 (71.4) | 15 (88.2) | 0.50 | 0.04 |
| Interpreting results of quality surveys (e.g. on quality indicators) | 68 (66.0) | 1 (1.0) | 25 (53.2) | 26 (74.3) | 14 (82.4) | 0.43 | 0.04 |
| Preparing or performing an internal benchmarking/quality follow‐up (i.e. comparing the results of the units within the NH/tracking the results over time) | 61 (59.2) | 1 (1.0) | 18 (37.5) | 26 (74.3) | 14 (82.4) | 0.66 | <0.01 |
| Preparing or performing an external benchmarking (i.e. comparing own NH's results with other NHs' results) | 44 (42.3) | 0 (0.0) | 13 (27.1) | 21 (60.0) | 8 (47.1) | 0.46 | 0.01 |
| Developing diagrams or graphs to display results of quality surveys | 42 (40.4) | 0 (0.0) | 14 (29.2) | 18 (51.4) | 9 (52.9) | 0.33 | 0.07 |
| Performance improvement projects | |||||||
| Implementing an intervention, a program or a quality improvement project | 93 (90.3) | 1 (1.0) | 41 (87.2) | 32 (91.4) | 16 (94.1) | 0.16 | 0.67 |
| PDSA: see Table 4 | |||||||
| Clinical teaching | 91 (87.5) | 0 (0.0) | 44 (91.7) | 30 (85.7) | 14 (82.4) | 0.19 | 0.52 |
| Offering modules/education to the team given by the RNX | 82 (80.4) | 2 (1.9) | 37 (80.4) | 28 (80.0) | 14 (82.4) | 0.04 | 0.98 |
| Offering modules/education to the team organized by the RNX (e.g. by inviting external speakers) | 64 (62.7) | 2 (1.9) | 22 (47.8) | 26 (74.3) | 13 (76.5) | 0.41 | 0.02 |
| Systematic analysis and systematic action | |||||||
| RCA and FMEA: see Table 4 | |||||||
| Leading or conducting case reviews | 82 (78.8) | 0 (0.0) | 34 (70.8) | 30 (85.7) | 15 (88.2) | 0.29 | 0.15 |
| Participating in the strategic planning of the NH | 63 (61.2) | 1 (1.0) | 23 (48.9) | 26 (74.3) | 10 (58.8) | 0.36 | 0.07 |
Note: No educational level could be attributed to n = 4 RNXs.
Abbreviations: CIRS, Critical Incident Reporting System; FMEA, Failure modes and effects analysis; NH, Nursing Home; PDSA, Plan‐Do‐Study‐Act cycle; RCA, Root cause analysis; RNXs, Nurses in expanded roles; SMD; Standardized mean difference.